Healthcare Provider Details

I. General information

NPI: 1386570596
Provider Name (Legal Business Name): DAVISAI PIZARRO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 JOHN DUFFY DR
JOPLIN MO
64804-1656
US

IV. Provider business mailing address

2225 S JACKSON AVE
JOPLIN MO
64804-1932
US

V. Phone/Fax

Practice location:
  • Phone: 417-212-5249
  • Fax:
Mailing address:
  • Phone: 787-918-0829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2026024297
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: